News

RIGHT Care team responds to mental health crisis calls

Parkland psychiatric social workers play key part in South Dallas pilot program

Feb. 18, 2019

“It could be a call from a worried mom saying ‘my son is using drugs.’ Or it could be someone reporting their neighbor is acting strangely. We’re prepared for the unpredictable because we‘re responding to crisis situations,” said Jana Creech, LCSW.

Creech is a seasoned psychiatric social worker with Parkland Health & Hospital System assigned to the RIGHT Care team, a pilot program launched in 2018 to provide rapid response to mental health emergency calls in south central Dallas, an area selected for the 3-year pilot because it has the highest level of 911 mental health calls in the city. The program is funded through a grant from The W.W. Caruth, Jr. Foundation at Communities Foundation of Texas.

The goal of RIGHT Care is to divert mental health patients from area emergency rooms and jails by stabilizing them on the scene and getting them to the appropriate preventive and intervention services that can meet their healthcare needs.

The first-of-its kind program in Texas, RIGHT Care is a partnership involving specially-trained paramedics from Dallas Fire-Rescue, Dallas Police Department officers and Parkland behavioral health social workers. Based at the South Central Dallas Police Station and working from a specially-equipped black Tahoe, they respond as a coordinated unit to safely and effectively manage patients experiencing behavioral health emergencies.

A Parkland psychiatric social worker is also assigned to the city-wide Dallas 911 call center to identify and triage emergency mental health calls, assign appropriate calls for response by the RIGHT Care field team, and provide support and resources to callers who are having behavioral health emergencies regardless of their locale in Dallas.

After 12 months collaborating in the field, the team has learned to work well together, Creech said. “We each bring the unique skills of our professional training and background to address patient needs for assistance and get them the help they need. Many of these individuals are very ill. We’re all focused on safety and doing what’s right for the patient.”

“A behavioral health crisis requires more than a police response,” said Kurtis Young, MSSW, LCSW, Social Work Director in Parkland’s Behavioral Health Department, noting, ”The largest provider of mental health services in Dallas is the county jail. RIGHT Care is demonstrating that more people can be treated effectively in their community.”

The RIGHT Care team responded to more than 2,500 mental health emergency 911 calls last year. While Parkland has seen an overall increase in mental health cases in 2018, there was a nearly10 percent decline in Parkland’s Psych ED volumes from ZIP codes served by RIGHT Care. The program diverted 31 percent of the calls they responded to from jails and hospital ERs by connecting patients to the resources in their community.

“Often those with severe mental illness are confused, medically unstable or dealing with substance use issues. In some cases, they may become aggressive, but many times we can avoid detention or an ER visit by making an appropriate care decision,” Creech explained. “That’s why it’s so important to have a multidisciplinary team of first responders specifically trained to help people with behavioral health problems. Together we determine the best action for each individual, which often is not hospital transport or emergency jail detention.”

Parkland social workers on the RIGHT Care team bring extensive behavioral health training and experience that enables them to fully assess the patient’s social and mental health needs. Helping patients find secure housing and social service resources along with clinically assessing a client is a part of the social workers’ responsibilities.

“We are trained to see the person as a whole. In addition to medical and psychiatric care, we connect them with the community resources they need, whether it’s food, shelter or access to other social services,” Creech said. The RIGHT Care team works closely with community agencies in the South Dallas area that provide social and mental health services, she said.

Proactive community outreach and intervention also includes follow-up services. The team averages four to six emergency cases per shift and performed more than 800 follow-up calls last year, checking on patients to ensure they are seeing their mental health provider, taking their medicine, have transportation to get to their doctor appointments, and removing any other barriers to care that are identified.

RIGHT Care collaborates with community partners such as Metrocare Services, North Texas Behavioral Health Authority, Integrated Psychotherapeutic Services, Child & Family Guidance Center and The Meadows Mental Health Policy Institute, along with area hospitals.

Although the job can be difficult and potentially dangerous at times, Creech enthusiastically endorses the RIGHT Care approach. “Yes, it’s challenging – but also very rewarding. We’re able to close the gaps in care for these patients,” she said.

Recently the family member of a mental health patient assisted by the RIGHT Care team recognized them on the street, a moment Creech said she’ll long remember. “The woman thanked us for saving her brother’s life. We know we’re making a difference in this area.”

Nearly one in five adults in Texas experiences mental illness each year. In Dallas County in 2016 there were nearly 427,000 behavior health visits by patients with mental health or substance use disorders, according to the DFW Hospital Council Foundation. In 2018, there were more than 1,000 patients per day incarcerated in the Dallas County Jail who had some form of mental illness.